Legacy contaminant trends in the Great Lakes uncovered by the wildlife environmental quality index.

Since the 1970s, wildlife managers have prioritized the recovery of Great Lakes ecosystems from contamination by Persistent Organic Pollutants (POPs). Monitoring and quantifying the region's recovery is challenged by the diversity of legacy contaminants in the environment and the lack of benchmarks for their potential biological effects. We address this gap by introducing the Wildlife Environmental Quality Index (WEQI) based on prior water and sediment quality indices. The tool summarizes, in a single score, the exposure of wildlife to harmful levels of multiple contaminants - with harmful levels set by published guidelines for protecting piscivorous wildlife from biological impacts. We applied the new index to a combined Canadian and American dataset of Herring Gull (Larus argentatus) egg data to elucidate trends in wildlife for eight legacy industrial pollutants and insecticides in the Great Lakes. Environmental quality of the Great Lakes region (as indexed by WEQI) improved by 18% between 2002 and 2017. Improvement came from reductions in both the scope of contamination (the number of guideline-exceeding contaminants) and its amplitude (the average size of guideline exceedances) at bird colonies. But recovery was unequal among lakes, with Lake Erie showing no improvement at one extreme. Weakly- or non-recovering lakes (Erie, Ontario, Huron) were marked by inconsistent improvement in scope and amplitude, likely due to ongoing loading, sediment resuspension and other stressors reported elsewhere. Fast-recovering lakes (Superior and Michigan), meanwhile, improved in both scope and amplitude. Contrasting trends and contaminant profiles (e.g., exceedances of PCBs versus DDTs) highlight the importance of lake-specific management for equalizing recoveries. Lower environmental quality at American than Canadian colonies, particularly in Lake Huron, further suggest uneven success in - and opportunities for - the binational management of wildlife exposure to legacy contaminants.

An integrated full-head OPM-MEG system based on 128 zero-field sensors.

Compact optically-pumped magnetometers (OPMs) are now commercially available with noise floors reaching 10 fT/Hz1/2. However, to be used effectively for magnetoencephalography (MEG), dense arrays of these sensors are required to operate as an integrated turn-key system. In this study, we present the HEDscan, a 128-sensor OPM MEG system by FieldLine Medical, and evaluate its sensor performance with regard to bandwidth, linearity, and crosstalk. We report results from cross-validation studies with conventional cryogenic MEG, the Magnes 3,600 WH Biomagnetometer by 4-D Neuroimaging. Our results show high signal amplitudes captured by the OPM-MEG system during a standard auditory paradigm, where short tones at 1000 Hz were presented to the left ear of six healthy adult volunteers. We validate these findings through an event-related beamformer analysis, which is in line with existing literature results.

Principles for collaborative risk communication: Reducing landslide losses in Puerto Rico.

Landslides are frequent and damaging natural hazards that threaten the people and the natural and built environments of Puerto Rico. In 2017, more than 70,000 landslides were triggered across the island by heavy rainfall from Hurricane María, prompting requests by local professionals for landslide education and outreach materials. This article describes a novel collaborative risk communication framework that was developed to meet those requests and shaped the creation of a Spanish- and English-language Landslide Guide for Residents of Puerto Rico. Collaborative risk communication is defined here as an iterative process guided by a set of principles for the interdisciplinary coproduction of hazards information and communication products by local and external stakeholders. The process that supports this form of risk communication involves mapping out the risk communication stakeholders in the at-risk or -disaster-affected location-in this case Puerto Rico-and collaborating over time to address a shared challenge, such as landslide hazards. The approach described in this article involved the formation of a core team of government and university partners that expanded in membership to conduct collaborative work with an informal network of hazards professionals from diverse sectors in Puerto Rico. The following principles guided this process: cultural competence, ethical engagement, listening, inclusive decision -making, empathy, convergence research, nested mentoring, adaptability, and reciprocity. This article contributes to the field of risk communication and emergency management by detailing these principles and the associated process in order to motivate collaborative risk communication efforts in different geographic and cultural contexts. While the work described here focuses on addressing landslides, the principles and process are transferable to other natural, technological, and willful human-caused hazards. They may also serve as a roadmap for future partnerships among government agencies and university researchers to inform the cocreation of science education and outreach tools.

Cross-Axis Dynamic Field Compensation of Optically Pumped Magnetometer Arrays for MEG.

We present dynamic field compensation (DFC), whereby three-axis field measurements from reference magnetometers are used to dynamically maintain null at the alkali vapor cells of an array of primary sensors that are proximal to a subject's scalp. Precision measurement of the magnetoencephalogram (MEG) by zero-field optically pumped magnetometer (OPM) sensors requires that sensor response is linear and sensor gain is constant over time. OPMs can be operated in open-loop mode, where the measured field is proportional to the output at the demodulated photodiode output, or in closed-loop, where on-board coils are dynamically driven to maintain the internal cell at zero field in the measurement direction. While OPMs can be operated in closed-loop mode along all three axes, this can increase sensor noise and poses engineering challenges. Uncompensated fluctuations in the ambient field along any statically nulled axes perturb the measured field by tipping the measurement axis and altering effective sensor gain - a phenomenon recently referred to as cross-axis projection error (CAPE). These errors are particularly problematic when OPMs are allowed to move in the remnant background field. Sensor gain-errors, if not mitigated, preclude precision measurements with OPMs operating in the presence of ambient field fluctuations within a typical MEG laboratory. In this manuscript, we present the cross-axis dynamic field compensation (DFC) method for maintaining zero field dynamically on all three axes of each sensor in an array of OPMs. Together, DFC and closed-loop operation strongly attenuate errors introduced by CAPE. This method was implemented by using three orthogonal reference sensors together with OPM electronics that permit driving each sensor's transverse field coils dynamically to maintain null field across its OPM measurement cell. These reference sensors can also be used for synthesizing 1st-gradient response to further reduce the effects of fluctuating ambient fields on measured brain activity and compensate for movement within a uniform field. We demonstrate that, using the DFC method, magnetic field measurement errors of less than 0.7% are easily achieved for an array of OPM sensors in the presence of ambient field perturbations of several nT.

Insulin expression in ß cells is reduced within islets before islet loss in diabetic cats.

OBJECTIVES: Diabetes mellitus is a common condition that requires intensive treatment and markedly impacts the welfare of affected cats. The aim of this study was to identify diabetes mellitus-associated perturbations in the feline pancreatic islet microenvironment. The utility of "clear, unobstructed brain/body imaging cocktails and computational analysis" (CUBIC) for three-dimensional pancreatic analysis was investigated. METHODS: Formalin-fixed paraffin-embedded tissues from cats with diabetes mellitus, or control cats without pancreatic pathology, were retrospectively identified. Immunohistochemistry for synaptophysin and ionised calcium binding adaptor molecule 1, and immunofluorescence for insulin and synaptophysin, were used to assess changes in islets. An image analysis pipeline was developed to analyse images acquired from two-dimensional immunofluorescence. CUBIC was used to optically clear selected pancreas samples before immunofluorescence and deep three-dimensional confocal microscopy. RESULTS: Diabetic cats have a significant reduction in synaptophysin-positive islet area. Whilst islets from diabetic patients have similar numbers of ß cells to islets from control cats, significantly lower intensity of insulin expression can be observed in the former. CUBIC facilitates clear visualisation of pancreatic islets in three dimensions. CLINICAL SIGNIFICANCE: The data presented support the theory that there is a decrease in function of ß cells before their destruction, suggesting a potentially significant step in the pathogenesis of feline diabetes mellitus. In parallel, we demonstrate CUBIC as a valuable new tool to visualise the shape of feline pancreatic islets and to interrogate pathology occurring in the islets of diabetic pets.

Antimicrobial resistance in Antarctica: is it still a pristine environment?

Although the rapid spread of antimicrobial resistance (AMR), particularly in relation to clinical settings, is causing concern in many regions of the globe, remote, extreme environments, such as Antarctica, are thought to be relatively free from the negative impact of human activities. In fact, Antarctica is often perceived as the last pristine continent on Earth. Such remote regions, which are assumed to have very low levels of AMR due to limited human activity, represent potential model environments to understand the mechanisms and interactions underpinning the early stages of evolution, de novo development, acquisition and transmission of AMR. Antarctica, with its defined zones of human colonisation (centred around scientific research stations) and large populations of migratory birds and animals, also has great potential with regard to mapping and understanding the spread of early-stage zoonotic interactions. However, to date, studies of AMR in Antarctica are limited. Here, we survey the current literature focussing on the following: i) Dissection of human-introduced AMR versus naturally occurring AMR, based on the premise that multiple drug resistance and resistance to synthetic antibiotics not yet found in nature are the results of human contamination ii) The potential role of endemic wildlife in AMR spread There is clear evidence for greater concentrations of AMR around research stations, and although data show reverse zoonosis of the characteristic human gut bacteria to endemic wildlife, AMR within birds and seals appears to be very low, albeit on limited samplings. Furthermore, areas where there is little, to no, human activity still appear to be free from anthropogenically introduced AMR. However, a comprehensive assessment of AMR levels in Antarctica is virtually impossible on current data due to the wide variation in reporting standards and methodologies used and poor geographical coverage. Thus, future studies should engage directly with policymakers to promote the implementation of continent-wide AMR reporting standards. The development of such standards alongside a centralised reporting system would provide baseline data to feedback directly into wastewater treatment policies for the Antarctic Treaty Area to help preserve this relatively pristine environment. Video Abstract.

Laryngopharyngeal reflux: is laparoscopic fundoplication an effective treatment?

INTRODUCTION: Laryngopharyngeal reflux (LPR) is difficult to diagnose and treat owing to uncertainty relating to the underlying pathology. The initial management of LPR includes lifestyle modifications and oral medications. In patients who have failed to respond to proton pump inhibitor (PPI) therapy, anti-reflux surgery is considered; laparoscopic fundoplication is the surgery of choice. The primary aim of this review is to identify whether fundoplication is effective in improving signs and symptoms of LPR. The secondary aim is to identify whether patients who have had a poor response to PPIs are likely to have symptom improvement with surgery. The objective of the study is to establish the effect of laparoscopic fundoplication on the reflux symptom index score (RSI). METHODS: PubMed, Embase, Medline and Cochrane databases were used to search according to the PRISMA guidelines. Original articles assessing the efficacy of fundoplication in relieving symptoms of LPR were included. For each study, the efficacy endpoints and safety outcomes were recorded. FINDINGS: Nine studies from 844 initial records met the inclusion criteria: one prospective case control study, one retrospective case-control study, four prospective case series and three retrospective case series involving 287 fundoplications. All nine studies found fundoplication to be effective in improving symptoms of LPR (p < 0.05). CONCLUSION: Current evidence suggests laparoscopic fundoplication is an effective treatment for LPR and should be considered if medical management is unsuccessful.

Laryngopharyngeal reflux: is laparoscopic fundoplication an effective treatment?

INTRODUCTION: Laryngopharyngeal reflux (LPR) is difficult to diagnose and treat owing to uncertainty relating to the underlying pathology. The initial management of LPR includes lifestyle modifications and oral medications. In patients who have failed to respond to proton pump inhibitor (PPI) therapy, anti-reflux surgery is considered; laparoscopic fundoplication is the surgery of choice. The primary aim of this review is to identify whether fundoplication is effective in improving signs and symptoms of LPR. The secondary aim is to identify whether patients who have had a poor response to PPIs are likely to have symptom improvement with surgery. The objective of the study is to establish the effect of laparoscopic fundoplication on the reflux symptom index score (RSI). METHODS: PubMed, Embase, Medline and Cochrane databases were used to search according to the PRISMA guidelines. Original articles assessing the efficacy of fundoplication in relieving symptoms of LPR were included. For each study, the efficacy endpoints and safety outcomes were recorded. FINDINGS: Nine studies from 844 initial records met the inclusion criteria: one prospective case control study, one retrospective case-control study, four prospective case series and three retrospective case series involving 287 fundoplications. All nine studies found fundoplication to be effective in improving symptoms of LPR (p < 0.05). CONCLUSION: Current evidence suggests laparoscopic fundoplication is an effective treatment for LPR and should be considered if medical management is unsuccessful.

Maternal Perceptions of Infant Behavior as a Potential Indicator of Parents or Infants in Need of Additional Support and Intervention.

The goal of the present study is to examine the relationship between early infant behaviors, which can be easily reported by parents, with parent-infant bonding and maternal mental health. It has long been established that child characteristics and behaviors have a significant impact on parent well-being and how parents respond to their infants. Examining parent perceptions of challenging infant behaviors may help health professionals identify high risk infants in need of intervention and mothers in need of additional support. Mothers of 73 infants between the ages of 3.5 weeks and 6 months filled out questionnaires. Infant stomach issues were positively correlated with bonding issues, maternal anxiety and maternal depression. Infant crying issues were also positively correlated with bonding issues, maternal anxiety and maternal depression. Potential clinical and research applications of the instrument include early identification of caregivers in need of support and screening for further clinical assessment and care.

Unusual Near-Horizon Cosmic-Ray-like Events Observed by ANITA-IV.

ANITA's fourth long-duration balloon flight in 2016 detected 29 cosmic-ray (CR)-like events on a background of 0.37_{-0.17}^{+0.27} anthropogenic events. CRs are mainly seen in reflection off the Antarctic ice sheets, creating a phase-inverted waveform polarity. However, four of the below-horizon CR-like events show anomalous noninverted polarity, a p=5.3×10^{-4} chance if due to background. All anomalous events are from locations near the horizon; ANITA-IV observed no steeply upcoming anomalous events similar to the two such events seen in prior flights.

Prevalence and performance effects of neonatal disease in Thoroughbred and Standardbred foals in South-Eastern Australia.

BACKGROUND: There is little information on foal mortality and the epidemiology of diseases in the neonatal period in Australian equine breeding enterprises. METHODOLOGY: This was a prospective cohort study of 1219 foals on 15 breeding farms in south-eastern Australia to identify the proportion of foals recognised on farm as abnormal at birth or within the first 48 h postpartum, determine the prevalence and risk factors for neonatal disease and assess the subsequent performance of foals in the study population. RESULTS: Overall, 27 foals died within 6 weeks of birth in the study population (2.2%), 142 foals (11.6%) were reported as abnormal at birth, and 304 (25.3%) were regarded as abnormal in the first 48 h postpartum. Non-septic orthopaedic disease (NSOD) was the most common abnormality recognised. Premature foals and foals born after dystocia or abnormal parturition were more likely to have clinical abnormalities recognised, but the intensity of nursing care did not predict outcome. Prophylactic administration of antimicrobial drugs was associated with increased mortality and septic disease. Maternal periparturient problems, foal gender, abnormality at birth and the presence of septic disease or neonatal maladjustment were associated with decreased performance outcomes, whereas measures to assess and augment passive immune transfer were associated with improved athletic performance. CONCLUSIONS AND RELEVANCE: Information in the current study is important for the treatment and management decisions on farm and to identify industry welfare and production priorities. Although the incidence of all outcome variables was variable, factors recognised on farm in the peri-parturient period were predictive of subsequent athletic performance.

Inter- and intra-observer reliability of the new AO/OTA classification of proximal femur fractures.

INTRODUCTION: Hip fractures are a global health burden, with an incidence that is projected to increase from 66,000/year currently in the United Kingdom to 100,000/year by 2033. The classification of intertrochanteric fractures is key to the treatment algorithms advising on their surgical management. The AO/OTA classification is the most commonly used system, initially published in 1990 and subsequently shown to have poor inter- and intra-observer reliability, it was revised in 2018 with the main aim of re-classifying and further defining the 31-A2 group. METHODS: 150 plain film anteroposterior and lateral plain film radiographs of intertrochanteric fractures from three hospitals were classified using the 2018 AO/OTA classification of intertrochanteric fractures by six Orthopaedic Surgeons (2 Consultants, 4 Trainees), all were blinded to the definitive surgical treatment for patients. Radiographs were re-classified after a minimum of 3-months, Cohen's Kappa for inter-observer reliability was calculated from first round classifications and intra-observer reliability from first and second classifications. RESULTS: Mean Kappa for inter-observer reliability for AO group classification (e.g. 31-A1) was 0.479 (0.220 - 0.771, for sub-group classification (e.g. 31-A1.1) reliability reduced to 0.376 (0.276 - 0.613). Intra-observer reliability was comparable for both group and sub-group classifications, 0.661 and 0.587 respectively. CONCLUSIONS: The revised 2018 AO/OTA classification aimed to simply the classification of intertrochanteric fractures, however it remains unreliable with only a "moderate" inter-observer reliability at group level with this falling to "fair" when sub-group classifications are made. Identification of stable and unstable injuries using the new AO/OTA system remains fraught with difficulties and appears difficult to apply with consistent accuracy.

The utility of Amies charcoal bacteriology swabs for storage of canine urine prior to culture.

OBJECTIVE: To determine the usefulness of bacteriology swabs as a storage method of canine urine samples and the effect on quantitative bacterial culture. MATERIALS AND METHODS: Two hundred fourteen canine urine samples were collected by cystocentesis. The reference aliquot was placed in a sterile tube and processed for quantitative bacterial culture within 6 hours. A bacteriology swab was then immersed in the urine for 5 seconds and returned to the charcoal Amies media container. The urine samples in the sterile tube and bacteriology swab were stored at room temperature for 48 hours and processed for quantitative bacterial culture. RESULTS: Thirty-seven of the samples were positive on reference culture with a total of 42 bacterial isolates. Samples stored in sterile tube and bacteriology swab had identical sensitivity and specificity for detection of bacteriuria (94.7% and 100%, respectively) with very good agreement (κ = 0.92; 95% CI 0.81 to 1.00). Agreement between the bacterial species of the reference sample and the bacteriology swab was higher (κ = 0.85; 95% CI 0.71 to 0.99) than compared to the sterile tube (κ = 0.78; 95% CI 0.62 to 0.94), but the overlapping confidence intervals mean improved agreement cannot be inferred. CLINICAL SIGNIFICANCE: Bacteriology swabs stored in Amies charcoal transport media should be considered an alternative method to preserve canine urine sample when immediate processing for quantitative bacterial culture is not possible. The sensitivity of culturing plain urine, stored for 48 hours in a sterile tube, for detection of bacteriuria, was higher than previously reported.

Scrubs contamination, domestic laundry effect and workwear habits of clinical staff at a referral hospital.

OBJECTIVE: To determine contamination rates of scrub suits worn by veterinary surgeons and nurses following a single shift. MATERIALS AND METHODS: Cross-sectional preliminary study at a UK small animal referral centre. Sterilised scrub suits were distributed to veterinary surgeons (n = 9) and nurses (n = 9) at the beginning of their clinical shift and worn for at least 8 hours. They were then analysed for bacterial contamination before and after home laundry at 30°C. A questionnaire was distributed to hospital clinical staff regarding workwear habits. RESULTS: Median bacterial counts were 47 (interquartile range: 14 to 162) and 7 (interquartile range: 0 to 27) colony forming units per cm2 before and after laundering scrub suits. Bacteria identified included Staphylococcus sp., Enterococcus sp., Escherichia coli , Bacillus sp., Pseudomonas aeruginosa , Micrococcus sp., ß-haemolytic Streptococci and a Group G Streptococcus. From 101 staff surveyed, 64.0% reported wearing fresh, clean scrub tops and 58.4% fresh, clean trousers each day, while 64.4% left the workplace wearing the same clothing in which they undertook clinical work. CLINICAL SIGNIFICANCE: Workwear contamination risks spread of pathogens into the community and personnel compliance with workplace guidelines warrants further attention. Home laundry at 30°C significantly decreases, but does not eliminate, the bacterial burden after a single shift.

Chlamydia psittaci infection as a cause of respiratory disease in neonatal foals.

BACKGROUND: During 2016-2018, 15 critically ill neonatal foals with acute respiratory distress associated with Chlamydia psittaci infection were presented to three referral hospitals in New South Wales. Chlamydia psittaci has not previously been associated with the development of neonatal respiratory disease. OBJECTIVES: To investigate and describe the clinical features and outcome of C. psittaci infection in neonatal foals. STUDY DESIGN: Multicentre retrospective case series. METHODS: The clinical, clinicopathological, necropsy and histological features of 15 foals with confirmed C. psittaci infection were reviewed and reported. RESULTS: Thirteen foals with C. psittaci infection died or were subjected to euthanasia within 36 h of hospitalisation and two foals survived to discharge. Findings during post-mortem examination of nonsurviving foals included bronchopneumonia, pulmonary congestion, hepatic congestion and hepatic inflammation. Detection of C. psittaci was achieved using polymerase chain reaction (PCR) testing of swabs of nasal secretions (4/6) and rectal mucosa (5/7) from live foals, lung tissues of foals at necropsy (11/14) and foetal membranes (4/5). MAIN LIMITATIONS: Small numbers of confirmed cases of neonatal C. psittaci infection and inconsistent sampling methods. CONCLUSIONS: Chlamydia psittaci should be considered a differential diagnosis for neonatal foals with signs of severe systemic disease, including equine neonatal acute respiratory distress syndrome (EqNARDS). Chlamydia psittaci is a zoonotic pathogen and a personal protective equipment (PPE) should be worn for the management of foals with suspected or confirmed infection.

Sources of elevated heavy metal concentrations in sediments and benthic marine invertebrates of the western Antarctic Peninsula.

Antarctica is one of the least anthropogenically-impacted areas of the world. Metal sources to the marine environment include localised activities of research stations and glacial meltwater containing metals of lithogenic origin. In this study, concentrations of nine metals (Cd, Co, Cr, Cu, Fe, Mn, Ni, Pb, Zn) were examined in three species of benthic invertebrates collected from four locations near Rothera Research Station on the western Antarctic Peninsula: Laternula elliptica (mudclam, filter feeder), Nacella concinna (limpet, grazer) and Odontaster validus (seastar, predator and scavenger). In addition, metals were evaluated in sediments at the same locations. Metal concentrations in different body tissues of invertebrates were equivalent to values recorded in industrialized non-polar sites and were attributed to natural sources including sediment input resulting from glacial erosion of local granodioritic rocks. Anthropogenic activities at Rothera Research Station appeared to have some impact on metal concentrations in the sampled invertebrates, with concentrations of several metals higher in L. elliptica near the runway and aircraft activities, but this was not a trend that was detected in the other species. Sediment analysis from two sites near the station showed lower metal concentrations than the control site 5 km distant and was attributed to differences in bedrock metal content. Differences in metal concentrations between organisms were attributed to feeding mechanisms and habitat, as well as depuration routes. L. elliptica kidneys showed significantly higher concentrations of eight metals, with some an order of magnitude greater than other organs, and the internal structure of O. validus had significantly higher Ni. This study supports previous assessments of N. concinna and L. elliptica as good biomonitors of metal concentrations and suggests O. validus as an additional biomonitor for use in future Antarctic metal monitoring programs.

Precision and accuracy of a point-of-care glucometer in horses and the effects of sample type.

Point-of-care glucometry is used commonly in clinical and research settings; however, accuracy and precision of this method are concerns. The objectives of this study were to determine the accuracy of glucometry in adult horses and the precision of duplicate measurements. Blood samples were collected from 62 horses into one plain syringe, one EDTA tube and three fluoride oxalate (FO) tubes. Immediately after collection, glucose concentrations in whole blood were determined, in duplicate, by glucometry from the syringe (plain whole blood [WB] group), EDTA tube (EDTA group) and one FO tube (FO group). One FO sample was used to measure plasma glucose concentration by a laboratory chemistry analyser (LAB group) ≤1 h after collection. The third FO tube was used to measure plasma glucose concentration by glucometry after 3 h storage (FO3hr group). Adequate precision was present for all groups (coefficient of variation: 0.7-3.5%) except WB (5.5-9.4%). Between groups, correlations were significant (P < 0.05; except for WB-EDTA), varied with group comparison, and tended to be lowest for comparisons involving WB. Mean bias was lowest for WB-LAB and greatest for FO-LAB and FO3hr-LAB; however, the limits of agreement were ≥4.65 mmol/L for WB-LAB and ≤2.75 mmol/L for most other comparisons. For the glucometer used, performance was influenced by sample type: WB was unsuitable, while FO or EDTA samples resulted in adequate precision and accuracy, provided under-estimation of glucose concentrations is accounted for by using method-specific reference ranges. Glucometer performance and optimal sample type(s) should be determined prior to use in horses.

Does idiopathic congenital talipes equinovarus have an impact on attainment of developmental milestones? A multicentre international study.

PURPOSE: The Ponseti method is a well-established approach to treating clubfoot. Potentially, both the underlying pathology and adherence to post-correction bracing can affect lower limb function and age of independent standing and walking. This cohort study investigates the age at which infants with idiopathic clubfoot treated using the Ponseti method achieved three selected developmental milestones and whether or not this correlated with treatment compliance. METHODS: A prospectively collected database from four centres was visited. Inclusion criteria were patients with idiopathic clubfoot with no comorbidities or prior treatment. Age at attainment of independent standing, walking, nocturnal continence was compared across three groups: I) congenital talipes equinovarus (CTEV) children compliant with treatment; II) CTEV children non-compliant with treatment; and III) typically-developed siblings. Minimum follow-up was five years. RESULTS: In all, 130 patients (198 feet) fitted the inclusion criteria: 43:87 (F:M). Standing was achieved by a mean 12.0 months in group I (sd 2.50); 12.0 months (sd 2.0) in II and ten months (sd 3.0) in III. Walking was achieved by a mean 15 months (sd 4.0) in group I, 14 months (sd 1.75) in II and 12 months (sd 3) in III, respectively. Both the compliant and non-compliant CTEV children were significantly slower at achieving standing and walking compared to sibling controls (p < 0.0001). There was no significant difference between age of nocturnal continence between the three groups. CONCLUSION: Infants with idiopathic clubfoot treated according to the Ponseti method achieve independent standing and walking approximately two months later than their typically-developed siblings. The delay is not related to the use of the foot abduction brace. LEVEL OF EVIDENCE: III.